<div>
    <span style="text-transform: uppercase; font-weight: bold">{translate}Assigment details{/translate}</span>
    <br/>
	<table cellpadding="5" cellspacing="0">
	    <tr>
	        <td style="width: 130px;"><span class="label">{translate}Service group{/translate}</span></td>
	        <td colspan="2">
	            <select name="radServiceGroup" id="radServiceGroup" style="width: 240px;">
	                <option value="0">- - {translate}Group{/translate} - -</option>
	                {html_options options=$groupList}
	            </select>
	        </td>
	    </tr>
	    <tr>
	        <td><span class="label">{translate}Service{/translate}</span></td>
	        <td>
	            <select name="radService" id="radService" style="width: 240px;">
	                <option value="0">- - {translate}Service{/translate} - -</option>
	            </select>
	        </td>
	        <td>
	            <input type="button" name="addRadServiceBtn" id="addRadServiceBtn" onclick="addRadService('radService', 'serviceListTbl');" value="{translate}Add{/translate}">
	        </td>
	    </tr>
	</table>
	
	<div class="separator"></div>
	<table id="serviceListTbl" class="grid" cellpadding="0" cellspacing="0">
	    <thead>
	         <tr>
	             <th class="first" style="width: 200px;">{translate}Service name{/translate}</th>
	             <th style="width: 80px;">{translate}Unit price{/translate}</th>
	             <th style="width: 80px;">{translate}Insurance payment{/translate}</th>
	             <th style="width: 80px;">{translate}Patient payment_1{/translate}</th>
	             <th class="last" style="width: 50px;">&nbsp;</th>
	         </tr>
	    </thead>
	    <tbody>
	       {if !empty($radItemList)} 
	           {foreach from=$radItemList item=radItem key=key}
	               <tr id="{$index}">
	                   <td>
	                       <input type="hidden" name="services[]" value="{$radItem.service_id}}">
	                       <span>{$radItem.name}</span>
                        </td>
                        <td><span id="price_{$index}">{$radItem.original_price}</span></td>
                        <td><span id="insPrice_{$index}">{$radItem.insurance_price}</span></td>
                        <td><span id="patPrice_{$index}">{$radItem.patient_price}</span></td>
                        <td class="action">
                            <a href="javascript:remove('serviceListTbl','{$index++}');" title="{translate}Delete{/translate}">
                                <img src="../images/remove_small.png"/>
                            </a>
                        </td>
	               </tr>
	           {/foreach}
	       {else}
	               <tr><td colspan="5">{translate}There is no information on services of the ticket{/translate}</td></tr>
	       {/if}
	        <tr id="total">
	            <td><span style="color: red;">{translate}Total{/translate}</span></td>
	            <td><span style="color: red;" id="totalPrice">{$total.original_price}</span></td>
	            <td><span style="color: red;" id="totalInsPrice">{$total.insurance_price}</span></td>
	            <td><span style="color: red;" id="totalPatPrice">{$total.patient_price}</span></td>
	            <td>&nbsp;</td>
	        </tr>
	    </tbody>
	 </table>
 <div>